Cases reported "Anemia"

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21/39. germanium poisoning: clinical symptoms and renal damage caused by long-term intake of germanium.

    We report five patients who have taken inorganic germanium preparations over a prolonged period. In all cases, the renal function deteriorated with no proteinuria or hematuria. Histological examination of the kidneys showed widespread tubular degeneration and interstitial fibrosis with minor glomerular abnormalities. Most patients had gastrointestinal symptoms such as vomiting, anorexia and weight loss; one patient had peripheral neuropathy and myopathy. A considerable amount of germanium was detected in the hair or nails of these patients. These cases clearly show that abuse of inorganic germanium compounds can induce renal damage with various extrarenal manifestations.
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ranking = 1
keywords = kidney
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22/39. Amelioration of anemia after kidney transplantation in severe secondary oxalosis.

    INTRODUCTION: In small bowel disease such as M. Crohn, the intestinal absorption of oxalate is increased. Severe calcium oxalate deposition in multiple organs as consequence of enteric hyperoxaluria may lead to severe organ dysfunction and chronic renal failure. The management of hemodialyzed patients with short bowel syndrome may be associated with vascular access problems and oxalate infiltration of the bone marrow leading to pancytopenia. Although the risk of recurrence of the disease is very high after renal transplantation, it may be the ultimate therapeutic alternative in secondary hyperoxaluria. CASE: Here, we report a patient with enteric oxalosis due to Crohn's disease. He developed end-stage renal disease, erythropoietin-resistant anemia, oxalate infiltration of the bone marrow and severe vascular access problems. Following high-urgency kidney transplantation, daily hemodiafiltration of 3 hours was performed for 2 weeks to increase oxalate clearance. Despite tubular and interstitial deposition of oxalate in the renal transplant, the patient did not require further hemodialysis and the hematocrit levels normalized. DISCUSSION: Early treatment of hyperoxaluria due to short bowel syndrome is essential to prevent renal impairment. Declining renal function leads to a further increase in oxalate accumulation and consecutive oxalate deposition in the bone marrow or in the vascular wall. If alternative treatments such as special diet or daily hemodialysis are insufficient, kidney transplantation may be a therapeutic alternative in severe cases of enteric oxalosis despite a possible recurrence of the disease.
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ranking = 6
keywords = kidney
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23/39. Management of pediatric patients with chronic kidney disease.

    Chronic kidney disease in children is associated with complications that require nursing interventions in both the inpatient and outpatient settings. Given the progressive nature of the disease and the complexity of the treatment regimen, it is important that nurses be comfortable implementing acute and preventive care strategies and facilitating the coordination of care. In addition, the need for multiple therapies can be distressing for patients and theirfamilies, further supporting the role of the nurse in patient and family education and decision making regarding the plan of care. In this review, we discuss the pertinent issues of pediatric chronic kidney disease in the context of a case study to promote better understanding of real-world nursing practice.
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ranking = 457.51567726418
keywords = kidney disease, kidney
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24/39. Case report: therapeutic embolization to control haematuria from transitional cell carcinoma of the kidney.

    A 66-year-old man presented with myocardial infarction precipitated by anaemia secondary to chronic haematuria from transitional cell carcinoma of the renal pelvis. Haematuria was controlled by therapeutic embolization of the renal artery until elective nephrectomy could be performed.
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ranking = 4
keywords = kidney
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25/39. review of patients' responses to epoetin alfa therapy.

    The efficacy of epoetin alfa (recombinant human erythropoietin) has been tested for treating the anemia associated with end-stage renal disease. This anemia is caused by severely decreased levels of erythropoietin, 90% of which is ordinarily produced by healthy kidneys. Treatment with epoetin alfa successfully corrected the anemia of 97% of 333 patients, as evidenced by hematocrit levels that increased by at least 6 percentage points or reached a study target level of 35%, 2 points above current guidelines. The 127 patients who previously required red cell transfusions to maintain an adequate hematocrit became completely transfusion independent after receiving epoetin alfa. Furthermore, treatment with this growth factor alleviated many of the symptoms of uremia, such as loss of energy and appetite. The major side effect observed with epoetin alfa treatment was increased diastolic blood pressure; however, this was well controlled by additional antihypertension medication. There have been no reports of antibody formation in response to this drug. Thus, epoetin alfa is a safe and effective means of treating the anemia caused by chronic renal insufficiency.
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ranking = 1
keywords = kidney
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26/39. Clinical importance of acquired cystic disease of the kidney in patients undergoing dialysis.

    From 1976 to 1982 five patients undergoing haemodialysis at Oxford Renal Unit suffered serious complications from acquired cystic disease of the kidney and two died as a direct result. Clinical features seen were pain, haematuria, palpable renal enlargement, massive haemorrhage, resolution of anaemia, and metastatic malignancy. The clinical histories emphasise the features of a disease that is likely to assume increasing importance in patients undergoing haemodialysis.
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ranking = 5
keywords = kidney
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27/39. Fatal hypervitaminosis a in a neonate.

    Although hypervitaminosis a is not uncommon, fatal cases are rare. We describe a neonate who died after having ingested more than 60 times the suggested dose of vitamin a per day, for 11 days. His hospital course was marked by hypercalcemia, hyperphosphatemia, a bleeding disorder, and pulmonary insufficiency. An autopsy showed extensive calcifications of the alveolar septa and bronchioles. Metastatic calcifications were also present in the kidneys, stomach, soft tissue, and skin. The skeleton showed prominent alteration of the endochondral bone formation. There was also evidence of accelerated resorption of bone, which is presumably responsible for the development of hypercalcemia and metastatic calcification.
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ranking = 1
keywords = kidney
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28/39. lymphangioma of kidney.

    lymphangioma of kidney is a rare, symptomatic but benign tumour. A case is reported and the literature reviewed. Aetiology and its effect on the incidence, non-invasive investigation, treatment and pathology are discussed.
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ranking = 5
keywords = kidney
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29/39. Microcytic normochromic anemia associated with iron storage by hypernephroma.

    A renal-cell carcinoma was discovered and resected in a 38-year-old female patient who had microcytic normochromic anemia. During treatment with ferrous gluconate, the anemia regressed temporarily but reappeared with the onset of metastases to the abdominal lymph nodes. Heavy deposits of hemosiderin were observed in tumor cells in the resected kidney and lymph nodal metastases. It is postulated that the anemia resulted from metabolic diversion and storage of iron by the tumor cells.
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ranking = 1
keywords = kidney
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30/39. Familial LCAT deficiency. Report of two patients from a Canadian family of Italian and Swedish descent.

    A 16-year-old male (S.F.) and his 21-year-old sister (D.H.) from a large family of Italian and Swedish descent had virtually identical lipoprotein pattern and complete absence of LCAT activity. Both had typical corneal opacities and mild anemia with target cells. S.F., but not D.H., presented with proteinuria, which has increased over three years of follow-up. His kidney biopsy revealed lipid deposits in the glomerular basement membrane. Ten relatives in 4 generations had normal LCAT activity and/or lipoprotein pattern. The patients and their relatives had haptoglobin type 2. Factors that might influence the different clinical presentation in our patients (previous renal disease, diet, abnormal lipoproteins), prognosis, and treatment (diet, enzyme replacement, cholestyramine) are discussed.
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ranking = 1
keywords = kidney
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